MEDICARE: PEACE OF MIND HOSPICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency		TX

General Provider Information

NPI Number	:	1114466505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND HOSPICE LLC

Provider Business Mailing Address
First Line	:	1844 LOCKHILL SELMA RD STE 101F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1503
Country	:	US
Telephone Number	:	210-994-5388
Fax Number	:	210-796-3049

Provider Business Practice Location Address
First Line	:	1844 LOCKHILL SELMA RD STE 101F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1503
Country	:	US
Telephone Number	:	210-994-5388
Fax Number	:	210-796-3049

Authorized Official
Title or Position	:	CFO
Name	:	ERIC ANTHONY PETERSEN
Credential	:
Telephone Number	:	210-679-1485

Provider Enumeration Date	:	02/17/2017
Last Update Date	:	03/23/2021

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Directions to “PEACE OF MIND HOSPICE LLC ” Practice Location

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